Rapid human immunodeficiency virus-1 testing on labor and delivery in 17 US hospitals: the MIRIAD experience
The objective of the study was to evaluate the feasibility, acceptability, and accuracy of rapid human immunodeficiency virus (HIV) testing during labor. The Mother-Infant Rapid Intervention at Delivery (MIRIAD) study was a prospective, multicenter study that offered voluntary, rapid HIV testing to women with undocumented HIV status at 17 hospitals in 6 cities. Of 12,481 eligible women, 74% were approached for participation and 85.5% of those approached accepted rapid HIV testing. Among 7753 women tested, MIRIAD identified 52 (0.7%) HIV-infected women. The time between obtaining the blood sample for the rapid test and reporting the results to the health care provider was shorter for hospitals utilizing point-of-care testing than in hospitals utilizing laboratory-based testing (30 minutes vs 68 minutes; P < .0001), and point-of-care testing strategies were 14 times more likely to have a short turnaround as laboratory testing strategies. Routine rapid testing during labor provides a feasible, acceptable, and accurate way to identify HIV-infected women before delivery.
1Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
2Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
3CORE Center, Stroger (formerly Cook County) Hospital, Chicago, IL
4Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, New Orleans, LA
5Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
6Department of Obstetrics and Gynecology, University of Miami School of Medicine, Miami, FL
7Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
8Medical and Health Research Association of New York City, New York, NY
9Johns Hopkins Medical School, Department of Pathology, onsite Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda
Reprints: Denise J. Jamieson, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop K-34, Atlanta, GA 30341
This research was supported by the National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, under cooperative agreements U64/217724, 417719, 517715, 617734, and 479935.
The views expressed herein are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention. Use of trade names is for identification purposes only and does not constitute endorsement by the Centers for Disease Control and Prevention or the Department of Health and Human Services.
ABSTRACT